Do you take a COVID-19 booster shot now or wait? Many wonder how best to weather the next wave of the pandemic

Gwyneth Paige didn’t want to get vaccinated against COVID-19[feminine] first. With her health issues – hypertension, fibromyalgia, asthma – she wanted to see how others were doing after the injections. Then her mother had colon cancer.

“At that time, I didn’t care if the vaccine killed me,” she said. “To be with my mother throughout her journey, I had to get vaccinated.”

Paige, who is 56 and lives in Detroit, received three doses. That leaves him with a short reminder of federal health recommendations.

Like Paige, who said she doesn’t currently plan on getting another recall, some Americans seem comfortable with the three-hit protection. But others may wonder what to do: boost again now with one of the original vaccines, or wait months for the promised new formulations suitable for the latest highly contagious Omicron subvariants, BA.4 and BA.5?

The rapidly mutating virus has created a conundrum for the public and a communication challenge for health officials.

“What we’re seeing now is a bit of an information vacuum that doesn’t help people make the right decision,” said Dr. Carlos del Rio, professor of infectious diseases at Emory University School of Medicine. .

Del Rio said the public doesn’t hear enough about the value of vaccines in preventing serious disease, even if they don’t stop all infections. Each new variant of COVID also forces health officials to change their messaging, del Rio said, which can add to public distrust.

According to data from the Centers for Disease Control and Prevention, about 70% of Americans ages 50 and older who received a first booster shot — and almost as many of those 65 and older — did not receive their second dose. reminder reminder. The agency currently recommends two booster shots after a series of primary vaccines for adults aged 50 and over and for younger people with weakened immune systems. Several news outlets recently reported that the Biden administration is working on a plan to allow all adults to get a second COVID booster.

Officials are concerned about the thrust from BA.4 and BA.5, which spread easily and can evade immune protection from previous vaccination or infection. A recent study published in Nature found that BA.5 was four times more resistant to mRNA vaccines than earlier Omicron subvariants.


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Consistency in messaging has been complicated by the differing views of leading vaccine scientists. Although doctors like del Rio and Dr. Peter Hotez of Baylor College of Medicine see value in getting a second booster, Dr. Paul Offit, a member of the FDA’s Vaccine Advisory Committee, is skeptical. immunocompromised.

“When experts have different views based on the same science, why are we surprised that getting the right message across is confusing?” said Dr. Bruce Gellin, head of global public health strategy at the Rockefeller Foundation and Offit’s colleague on the FDA panel.

Janet Perrin, 70, of Houston, did not receive her second booster for scheduling and convenience reasons and said she would seek information on a variant-targeted dose from sources she trusts on social networks. “I couldn’t find a consistent voice from the CDC,” she said, and the agency’s statements sound like “a salad of political words.”

On July 12, the Biden administration released its management plan for the BA.5 subvariant, which it said would have the greatest impact in parts of the country with lower vaccine coverage. The strategy is to make it easier for people to access tests, vaccines and boosters, as well as COVID antiviral treatments.

At the White House’s first COVID briefing in nearly three weeks, the message from top federal health officials was clear: Don’t wait for a tailor-made vaccine for Omicron. “There are a lot of people who are high risk right now, and waiting until October, November for their boost – when in fact their risk is right now – is not a good idea. plan,” said CDC chief Dr. Rochelle Walensky. .

With concerns about the growth of the BA.5 subvariant, the FDA recommended on June 30 that drugmakers Pfizer-BioNTech and Moderna get to work producing a new bivalent vaccine that combines the current version with a formulation which targets new strains.

The companies both say they can make millions of doses of reformulated vaccines available to the United States in October. Experts believe that time frame could slip by a few months given the unexpected issues affecting vaccine manufacturing.

“I think we’ve all asked ourselves the same question,” said Dr. Kathryn Edwards, scientific director of the Vanderbilt Vaccine Research Program. “What’s the benefit of getting another booster now when what’s coming out in the fall is a bivalent vaccine and you’ll be getting the BA.4/5, which is currently circulating? Although it’s circulating in the fall is another matter.”

On July 13, the FDA authorized a fourth COVID vaccine, made by Novavax, but only for people who have not yet been vaccinated. Many scientists believed that the Novavax vaccine could be an effective booster for people previously vaccinated with mRNA vaccines from Pfizer-BioNTech and Moderna because its unique design could broaden the immune response to coronaviruses. Unfortunately, few studies have evaluated mixed vaccination approaches, said Gellin of the Rockefeller Foundation.

Edwards and her husband contracted COVID in January. She received a second reminder last month, but only because she thought it might be necessary for a business trip to Canada. Otherwise, she said, she felt a fourth shot was kind of wasteful, but not particularly risky. She told her husband – a healthy septuagenarian – to wait for the BA.4/5 version.

People at very high risk for complications from COVID might want to go ahead and get a fourth dose, Edwards said, in hopes it will temporarily prevent serious illness “while you wait for BA.4/5.”

Omicron vaccines will contain components that target the original strain of the virus, as early vaccine formulations are known to prevent serious illness and death, even in people infected with Omicron.

These components will also help control earlier strains of the virus, said Dr. David Brett-Major, an infectious disease specialist at the University of Nebraska Medical Center. This is important, he said, because too much adaptation of vaccines to fight emerging variants could allow older strains of the coronavirus to resurface.

Brett-Major said messages about the value of personalized injections will need to come from trusted local sources — not just top federal health officials.

“Access is locally,” he said. “If your on-premises systems aren’t messaging, promoting, and enabling access, that’s really problematic.”

Although some Americans are wondering when or if they should get their second booster, many people disconnected from the pandemic long ago, putting them at risk during the current wave, experts said.

Dr Georges Benjamin, executive director of the American Public Health Association, said he doesn’t expect to see the level of public interest in the vaccine change much, even if new reminders are issued and the eligibility expands. Areas of the country with high vaccine coverage will remain relatively isolated from new variants that emerge, he said, while areas with low vaccine acceptance could be set for a “rude awakening”.

Even scientists don’t know how to effectively adapt to an ever-changing virus.

“Nothing is simple with COVID, is it? It’s just a mole,” Edwards said. “This morning I heard about a new variant in India. Maybe it’ll be nothing, but – who knows? – maybe something big, and then we’ll be like, ‘Why did- we changed the vaccine strain to BA.4/ 5?'”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the three main operating programs of KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization providing information on health issues to the nation.

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